scholarly journals Clinical characteristics, treatment and outcome of adnexal torsion in pregnant women: a retrospective study

2020 ◽  
Author(s):  
Yong-xue Wang ◽  
Shan Deng
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Clinical Characteristics ◽  
Ovarian Function ◽  
Fetal Loss ◽  
Conservative Surgery ◽  
Intrauterine Fetal Death ◽  
Adnexal Torsion ◽  
Tertiary Center

Abstract Background: Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women.Methods: A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed.Results: The median age of the patients was 28 (range, 18-38) years. The median gestational age was 11 (range, 6-31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p<0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence during the same pregnancy. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births.Conclusion: Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.

scholarly journals Clinical characteristics, treatment and outcome of adnexal torsion in pregnant women: a retrospective study

2020 ◽  
Author(s):  
Yong-xue Wang ◽  
Shan Deng
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Clinical Characteristics ◽  
Ovarian Function ◽  
Fetal Loss ◽  
Conservative Surgery ◽  
Intrauterine Fetal Death ◽  
Adnexal Torsion ◽  
Tertiary Center

Abstract Background: Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women.Methods: A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed.Results: The median age of the patients was 28 (range, 18-38) years. The median gestational age was 11 (range, 6-31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p<0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence during the same pregnancy. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births.Conclusion: Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.

scholarly journals Clinical Characteristics, Treatment and Outcome of Adnexal Torsion in Pregnant Women: A Retrospective Study

2020 ◽  
Author(s):  
Shan Deng ◽  
Yong-xue Wang
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Clinical Characteristics ◽  
Ovarian Function ◽  
Fetal Loss ◽  
Conservative Surgery ◽  
Intrauterine Fetal Death ◽  
Adnexal Torsion ◽  
Tertiary Center

Abstract Background Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women.Methods A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed.Results The median age of the patients was 28 (range, 18–38) years. The median gestational age was 11 (range, 6–31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p < 0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births.Conclusion Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function. Cystectomy could reduce the risk of recurrence.

scholarly journals Clinical characteristics, treatment and outcome of adnexal torsion in pregnant women: 10-year experience

2020 ◽  
Author(s):  
Yong-xue Wang ◽  
Shan Deng
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Clinical Characteristics ◽  
Ovarian Function ◽  
Fetal Loss ◽  
First Trimester ◽  
Conservative Surgery ◽  
Intrauterine Fetal Death ◽  
Adnexal Torsion ◽  
Tertiary Center

Abstract Background Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women. Methods A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed. Results The median age of the patients was 28 (range, 18–38) years. The median gestational age was 11 (range, 6–31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p < 0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births. Conclusion Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function. Cystectomy could reduce the risk of recurrence.

scholarly journals Maternal and perinatal characteristics and outcomes of pregnancies complicated with COVID-19 in Kuwait

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amal Ayed ◽  
Alia Embaireeg ◽  
Asmaa Benawadh ◽  
Wadha Al-Fouzan ◽  
Majdeda Hammoud ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Live Birth ◽  
Gestational Age ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Intrauterine Fetal Death ◽  
Nasopharyngeal Swab ◽  
The Public ◽  
Fluctuating Course ◽  
Gestational Age At Birth

Abstract Background The effect of SARS-CoV-2 infection in pregnant women and newborns is incompletely understood. Preliminary data shows a rather fluctuating course of the disease from asymptomatic or mild symptoms to maternal death. However, it is not clear whether the disease increases the risk of pregnancy-related complications. The aim of the study is to describe the maternal and neonatal clinical characteristics and outcome of pregnancies with SARS-CoV-2 infection. Methods In this retrospective national-based study, we analyzed the medical records of all pregnant women infected with SARS-CoV-2 and their neonates who were admitted to New-Jahra Hospital (NJH), Kuwait, between March 15th 2020 and May 31st 2020. During the study period and as part of the public health measures, a total of 185 pregnant women infected with SARS-CoV-2, regardless of symptoms, were hospitalized at NJH, and were included. Maternal and neonatal clinical manifestations, laboratory tests and treatments were collected. The outcomes of pregnancies included miscarriage, intrauterine fetal death (IUFD), preterm birth and live birth were assessed until the end date of the outcomes follow-up (November 10th 2020). Results A total of 185 pregnant women infected with SARS-CoV-2 were enrolled with a median age of 31 years (interquartile range, IQR: 27.5–34), and median gestational age at diagnosis of SARS-CoV2 infection was 29 weeks (IQR: 18–34). The majority (88%) of these women had mild symptoms, with fever (58%) being the most common presenting symptom followed by cough (50.6%). At the time of the analysis, out of the 185, 3 (1.6%) of the pregnant women had a miscarriage, 1 (0.54%) had IUFD which was not related to COVID-19, 16 (8.6%) had ongoing pregnancies and 165 (89%) had a live birth. Only 2 (1.1%) of these women developed severe pneumonia and required intensive care. A total of 167 neonates with two sets of twins were born with median gestational age at birth was 38 (IQR: 36–39) weeks. Most of the neonates were asymptomatic, and only 2 of them tested positive on day 5 by nasopharyngeal swab testing. Conclusions In this national-based study, most of the pregnant women infected with SARS-CoV-2 showed mild symptoms. Although mother-to-child vertical transmission of SARS-CoV-2 is possible, COVID-19 infection during pregnancy may not lead to unfavorable maternal and neonatal outcomes.

scholarly journals Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Fetal Membrane ◽  
Delivery Mode ◽  
Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

scholarly journals Clinical characteristics and sociodemographic factors associated with COVID-19 infection in pregnant women in a maternal and children's public hospital

Medwave ◽  
2021 ◽  
Vol 21 (07) ◽  
pp. e8442-e8442
Author(s):  
Yda Rodriguez Huaman ◽  
Pavel J Contreras ◽  
Michelle Lozada-Urbano
Keyword(s):  
Body Mass Index ◽  
Marital Status ◽  
Pregnant Women ◽  
Body Mass ◽  
Gestational Age ◽  
Lower Risk ◽  
Clinical Characteristics ◽  
Prevalence Ratio ◽  
Sociodemographic Factors ◽  
Factors Associated

Objective To describe the clinical characteristics and sociodemographic factors associated with COVID-19 among pregnant women in a maternal and children's hospital in Lima, Peru. Methods Quantitative observational study. The population under study consisted of pregnant women who attended an emergency room and had a COVID-19 test. These women were assessed for age, gestational age, place of origin, occupation, education, marital status, number of children, previous body mass index, gestational body mass index, tetanus vaccination, prenatal controls, and hemoglobin. After bivariate analysis, a generalized linear regression model was applied. Results We included 200 women aged between 18 and 34 years (84.5%) with a median gestational age of 36 weeks. More than half were from Lima (52.5%), most were housewives (79%), had high school education (71.9%), and had a cohabiting marital status (60%). The COVID-19 test positivity was 31.5% by rapid tests. Pregestational body mass index assessment showed that 36.7% of normal weight, 38,1% of overweight, and 30.3% of obese pregnant women had COVID-19 infection. 39.7% of patients with hemoglobin levels greater than or equal to 11 g/dL, 21.2% of patients with values between 10 and 10.9 g/dL, and 20% of patients with values between 7 and 9.9 g/dL had COVID-19 infection. The prevalence ratio (with a 95% confidence interval) found that cohabitation was associated with a lower risk of having COVID-19 infection in pregnant women (prevalence ratio: 0.41, p < 0.001). Conclusion Cohabiting pregnant women had a lower risk of COVID-19 infection compared with other marital statuses. Further research is needed to evaluate COVID-19 associated factors in pregnant women and possible sociodemographic or economic factors behind cohabiting marital status association among this population.

scholarly journals Clinical Characteristics of 47 Death Cases With COVID-19: A Retrospective Study at a Tertiary Center in Lahore

Cureus ◽  
2020 ◽  
Author(s):  
Ahmad Ussaid ◽  
Babar Riaz ◽  
Wajid Rafai ◽  
Sohail Anwar ◽  
Faisal Baig ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Characteristics ◽  
Tertiary Center ◽  
Death Cases

Furcate insertion of the umbilical cord: pathological and clinical characteristics in 132 cases

2020 ◽  
Vol 48 (8) ◽  
pp. 819-824
Author(s):  
Philipp Kosian ◽  
Wolfgang Henrich ◽  
Michael Entezami ◽  
Alexander Weichert
Keyword(s):  
Retrospective Study ◽  
Umbilical Cord ◽  
Perinatal Outcome ◽  
Clinical Characteristics ◽  
Fetal Death ◽  
University Hospital ◽  
Intrauterine Fetal Death ◽  
Pathological Characteristics ◽  
Umbilical Vessel ◽  
Vessel Rupture

AbstractObjectivesFurcate cord insertion is a rare abnormality affecting approximately 0.1% of all pregnancies. Macroscopically, the umbilical vessels separate before reaching the placenta, lose their Wharton’s jelly, and insert at the placenta centrally, eccentrically, or marginally. The aim of this retrospective study was to determine the prevalence of furcate cord insertion more accurately, the pathological characteristics, and clinical outcomes.MethodsWe conducted a retrospective study of 132 cases of furcate insertion of the umbilical cord using the pathological database of the Charité University Hospital Berlin, Germany, between 1993 and 2016. This included 99 cases, including one termination of pregnancy within our institution and 33 cases from external hospitals. An analysis of the pathological features of the 132 cases and the perinatal outcome of the 98 cases within our institution were performed.ResultsFurcate cord insertion occurred in 0.16% pregnancies. Of the 132 cases, seven cases of intrauterine fetal deaths were observed. Three of those could be linked to the furcate cord insertion. In two of those cases, single umbilical vessel rupture was identified as the cause of fetal death.ConclusionsIn most cases of furcate cord insertion, the outcome is good; however, intrauterine fetal death occurs in approximately 1.02% of cases.

Expectant Management in Twin Pregnancies With Discordant Structural Fetal Anomalies

2011 ◽  
Vol 14 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Ingeborg H. Linskens ◽  
Ruurd M. van Elburg ◽  
Dick Oepkes ◽  
John M. G. van Vugt ◽  
Monique C. Haak
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Expectant Management ◽  
Premature Delivery ◽  
Fetal Anomalies ◽  
Comfort Care ◽  
Increased Risk ◽  
Tertiary Center ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies

Objective:Routine obstetric ultrasound increasingly leads to the detection of structural fetal anomalies. In twin pregnancies with one anomalous twin, counseling on management strategies is complicated. Patients and methods: Twin pregnancies (n= 212) were referred to a tertiary center between January 2007 and July 2009. In a retrospective analysis, twins discordant for a structural fetal anomaly were compared to twins without anomalies in the prenatal ultrasound. Outcome parameters were survival and gestational age at birth.Results:Anomalies were seen in at least one fetus of 30 twin pairs. The two pregnancies in which the anomalies were concordant were terminated. Selective feticide was performed in three cases of major but non-lethal anomalies in dichorionic twins. The remaining 25 cases were managed expectantly. In three of these cases, spontaneous fetal demise of the affected fetus was observed. In five cases with major (lethal) anomalies, the pregnant women and their partners opted for non-intervention comfort care after birth for the affected fetus. Median gestational age at delivery was 257 days for twins without structural anomalies and was 254 days (n= 22) for twins with one anomalous fetus. This was not significantly different (Mann Whitney U,p= .69). Again, no difference was found for median gestational age at delivery in normal vs. discordant anomalous dichorionic twins if subdivided for chorionicity (Mann Whitney U,p= .68).Conclusion:In this cohort we describe the request for expectant management by pregnant women and their partners of those twins discordant for major (lethal) anomalies. Expectant management was not associated with increased risk of premature delivery. Fetocide was only opted for in a small number of cases with severe but non-lethal anomalies in dichorionic twins.

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